Hildegard Peplau

From Wikipedia, the free encyclopedia
Jump to: navigation, search

Hildegard E. Peplau (September 1, 1909 - March 17, 1999)[1] was an American nurse and the first published nursing theorist since Florence Nightingale and created the middle-range nursing theory of interpersonal relations, which helped to revolutionize the scholarly work of nurses. As a primary contributor to mental health law reform, she led the way towards humane treatment of patients with behavior and personality disorders.[2][3]

Biography[edit]

Early life[edit]

Hilda was born in Reading, Pennsylvania to immigrant parents of German descent, Gustav and Otyllie Peplau. She was the second daughter born of six children. Gustav was an illiterate, hard-working father and Otyllie was an oppressive, perfectionist mother. Though higher education was never discussed at home, Hilda was strong-willed, with motivation and vision to grow beyond traditional women’s roles. She wanted more out of life and knew nursing was one of few career choices for women in her day.[4] As a child, she witnessed the devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families.[5]

In the early 1900s, the autonomous, nursing-controlled, Nightingale era schools came to an end – schools became controlled by hospitals, and formal "book learning" was discouraged. Hospitals and physicians saw women in nursing as a source of free or inexpensive labor. Exploitation was not uncommon by nurse’s employers, physicians and educational providers. Nursing practice was controlled by medicine.[6]

Career[edit]

Peplau began her career in nursing in 1931 as a graduate of the Pottstown Hospital School of Nursing in Pottstown, PA. She then worked as a staff nurse in Pennsylvania and New York City. A summer position as nurse for the New York University summer camp led to a recommendation for Peplau to become the school nurse at Bennington College in Vermont. There she earned a bachelor’s degree in interpersonal psychology in 1943. At Bennington and through field experiences at Chestnut Lodge, a private psychiatric facility, she studied psychological issues with Erich Fromm, Frieda Fromm-Reichmann, and Harry Stack Sullivan. Peplau’s lifelong work was largely focused on extending Sullivan’s interpersonal theory for use in nursing practice.[7]

From 1943 to 1945 she served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital in England, where the American School of Military Psychiatry was located. Here she met and worked with leading figures in British and American psychiatry. After the war, Peplau was at the table with many of these same men as they worked to reshape the mental health system in the United States through the passage of the National Mental Health Act of 1946.[8]

Peplau held master’s and doctoral degrees from Teachers College, Columbia University. She was also certified in psychoanalysis at the William Alanson White Institute of New York City. In the early 1950s, Peplau developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Dr. Peplau was a member of the faculty of the College of Nursing at Rutgers University from 1954 to 1974. At Rutgers, Peplau created the first graduate level program for the preparation of clinical specialists in psychiatric nursing.[9]

She was a prolific writer and was equally well known for her presentations, speeches, and clinical training workshops. Peplau vigorously advocated that nurses should become further educated so they could provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospitals of that era. During the 1950s and 1960s, she conducted summer workshops for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques, as well as individual, family, and group therapy.

Peplau was an advisor to the World Health Organization and was a visiting professor at universities in Africa, Latin America, Belgium, and throughout the United States. A strong advocate for graduate education and research in nursing, she served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institute of Mental Health. She participated in many government policy-making groups. She served as president of the American Nurses Association from 1970 to 1972 and a second vice president from 1972 to 1974.[10] After her retirement from Rutgers, she served as a visiting professor at the University of Leuven[disambiguation needed] in Belgium in 1975 and 1976.[11]

She died peacefully in her sleep at home in Sherman Oaks, California.[12]

Theoretical work[edit]

In her interpersonal relationship theory, Dr. Peplau emphasized the nurse-client relationship as the foundation of nursing practice. Her book on her conceptual framework, Interpersonal Relations in Nursing, was completed in 1948. Publication took four additional years because it was groundbreaking for a nurse to contribute this scholarly work without a coauthoring physician.[13][14]

At the time, her research and emphasis on the give-and-take of nurse-client relationships was seen by many as revolutionary. Peplau went on to form an interpersonal model emphasizing the need for a partnership between nurse and client as opposed to the client passively receiving treatment (and the nurse passively acting out doctor's orders).

The essence of Peplau's theories is the creation of a shared experience. Nurses, she thought, could facilitate this through observation, description, formulation, interpretation, validation, and intervention.

For example, as the nurse listens to her client she develops a general impression of the client's situation. The nurse then validates her inferences by checking with the client for accuracy. The result may be experiential learning, improved coping strategies, and personal growth for both parties.

Peplau's model[edit]

Peplau's model has proved of great use to later nurse theorists and clinicians in developing more sophisticated and therapeutic nursing interventions

Peplau's Seven Nursing Roles[edit]

Peplau's Seven Nursing Roles illustrate the dynamic character roles typical to clinical nursing.

  1. Stranger role: Receives the client the same way one meets a stranger in other life situations; provides an accepting climate that builds trust.
  2. Resource role: Answers questions, interprets clinical treatment data, gives information.
  3. Teaching role: Gives instructions and provides training; involves analysis and synthesis of the learner's experience.
  4. Counseling role: Helps client understand and integrate the meaning of current life circumstances; provides guidance and encouragement to make changes.
  5. Surrogate role: Helps client clarify domains of dependence, interdependence, and independence and acts on clients behalf as advocate.
  6. Active leadership: Helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way.
  7. Technical expert role: Provides physical care by displaying clinical skills; Operates equipment[15]

Peplau's Developmental Stages of the Nurse-Client Relationship[edit]

Orientation Phase[edit]

  • Get acquainted phase of the nurse-patient relationship.
  • Preconceptions are worked through
  • Parameters are established and met
  • Early levels of trust are developed
  • Roles begin to be understood

Identification Phase[edit]

  • The client begins to identify problems to be worked on within relationship
  • The goal of the nurse: help the patient to recognize his/her own interdependent/participation role and promote responsibility for self

Exploitation Phase[edit]

  • Client’s trust of nurse reached full potential
  • Client making full use of nursing services
  • Solving immediate problems
  • Identifying and orienting self to [discharge] goals

Resolution Phase[edit]

  • Client met needs
  • Mutual termination of relationship
  • Sense of security is formed
  • Patient is less reliant on nurse
  • Increased self-reliance to deal with own problems.

[16][17]

See also[edit]

References[edit]

  1. ^ Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York: Springer.
  2. ^ O’Toole, A. W., & Welt, S. R. (Ed.). (1989). Interpersonal theory in nursing practice: Selected works of Hildegarde E. Peplau. New York: Springer.
  3. ^ Tomey, A. M., & Alligood, M. R. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby.
  4. ^ Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York: Springer.
  5. ^ Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York: Springer.
  6. ^ Chinn, P. L. (2008). Integrated theory and knowledge development in nursing (7th ed.). St. Louis, MO: Mosby.
  7. ^ Forchuk, C. (1993). Hildegarde E. Peplau: Interpersonal nursing theory – Notes on nursing theories (10). Newbury Park, CA: Sage.
  8. ^ Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York: Springer.
  9. ^ O’Toole, A. W., & Welt, S. R. (Ed.). (1989). Interpersonal theory in nursing practice: Selected works of Hildegarde E. Peplau. New York: Springer.
  10. ^ Howk, C.(2002).Hildegard Peplau: Psychodynamic Nursing.In A, Tomey & M,Alligood(Eds.).Nursing Theorists and Their Work (5th ed. pp.379 - 382).St.Louis, MO: Mosby.
  11. ^ Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. New York: Springer.
  12. ^ Howk, C. (2002). Hildegard E. Peplau: Psychodynamic nursing. In A. Tomey & M. Alligood (Eds.), Nursing theory and their work (5th ed.,pp. 379). St. Louis, MO: Mosby.
  13. ^ Forchuk, C. (1993). Hildegarde E. Peplau: Interpersonal nursing theory – Notes on nursing theories (10). Newbury Park, CA: Sage.
  14. ^ O’Toole, A. W., & Welt, S. R. (Ed.). (1989). Interpersonal theory in nursing practice: Selected works of Hildegarde E. Peplau. New York: Springer.
  15. ^ Forchuk, C. (1993). Hildegarde E. Peplau: Interpersonal nursing theory – Notes on nursing theories (10). Newbury Park, CA: Sage.
  16. ^ Belcher, J. R., & Brittain-Fish, L. J., (2002). Interpersonal Relations in Nursing: Hildegard E. Peplau. In J. George (Ed.), Nursing theories: The base for professional nursing practice (5th ed.)(pp. 61-82). Upper Saddle River, NJ: Prentice Hall.
  17. ^ Peterson, S. J., (2009). Interpersonal Relations. In S. Peterson & T. Bredow (Eds.), Middle range theories: Applications to nursing research (2nd Ed.)(pp. 202-230). Philadelphia, PA: Lippincott Williams & Wilkins.

External links[edit]